胆囊后入路腹腔镜切除术对胆囊结石合并慢性胆囊炎患者术后恢复、疼痛应激的影响  

Effects of laparoscopic cholecystectomy via posterior gallbladder approach on postoperative recovery and pain stress in patients with gallstones and chronic cholecystitis

作　　者：桂新华 胡婷 于海 Gui Xin-hua;Hu Ting;Yu Hai(Department of General Surgery,Dongxiang District People's Hospital,Fuzhou 331800,Jiangxi,China)

机构地区：[1]东乡区人民医院普外科,江西抚州331800

出　　处：《四川生理科学杂志》2025年第1期206-208,共3页

摘　　要：目的:观察胆囊后入路腹腔镜切除术(Laparoscopic Cholecystectomy,LC)对胆囊结石合并慢性胆囊炎患者术后恢复、疼痛应激的影响。方法:选取我院2022年1月至2023年12月70例胆囊结石合并慢性胆囊炎患者,根据手术方式不同分为A组(LC常规解剖入路)和B组(LC胆囊后三角解剖入路),各34例、36例,观察术后恢复情况、疼痛程度以及炎症应激指标。结果:B组术中出血量少于A组,手术时间、肠鸣音恢复、住院时间短于A组(P<0.05);术后12 h、24 h,两组疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分降低且B组明显低于A组(P<0.05);术后3 d,两组炎症应激指标均上升,B组白细胞介素-6、C反应蛋白、白细胞计数水平明显低于A组(P<0.05)。结论:LC胆囊后三角解剖入路对改善胆囊结石合并慢性胆囊炎患者手术指标较好,有利于患者术后恢复,还可减少术后疼痛情况与炎症应激。Objective:To observe the effects of laparoscopic cholecystectomy(LC)via posterior gallbladder approach on postoperative recovery and pain stress in patients with gallstones and chronic cholecystitis.Methods:Seventy patients with gallstones and chronic cholecystitis who were admitted to the hospital from January 2022 to December 2023 were selected.According to different surgical methods,patients enrolled were divided into group A(34 cases undergoing LC via anatomical approach of convention)and group B(36 cases undergoing LC via anatomical approach of posterior Calot's triangle).Postoperative recovery,pain degree,and inflammatory stress indicators were observed.Results:Intraoperative blood loss,operation time,bowel sounds recovery time,and hospital stay of group B were less and shorter than those of group A(P<0.05).At 12 hours and 24 hours after operation,the Visual Analogue Scale(VAS)scores for pain decreased in both groups,and group B had significantly lower scores than group A(P<0.05).On day 3 after operation,both groups showed an increase in inflammatory stress indicators.The levels of interleukin-6,C-reactive protein,and white blood cell count in group B were significantly lower than those in group A(P<0.05).Conclusion:LC via anatomical approach of posterior Calot's triangle improves the surgical index in patients with gallstones and chronic cholecystitis,facilitates the patients’postoperative recovery,and can reduce postoperative pain and inflammatory stress.

关 键 词：腹腔镜胆囊切除术 胆囊解剖入路 CALOT三角 胆囊结石 慢性胆囊炎 

分 类 号：R657.4[医药卫生—外科学]